Provider Demographics
NPI:1043512072
Name:RICHARD L KREITER MD PC
Entity Type:Organization
Organization Name:RICHARD L KREITER MD PC
Other - Org Name:ORTHOPEDIC CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:KREITER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:563-333-2000
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52805-0219
Mailing Address - Country:US
Mailing Address - Phone:563-333-2000
Mailing Address - Fax:563-359-5642
Practice Address - Street 1:1820 W 3RD ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52802-1812
Practice Address - Country:US
Practice Address - Phone:563-333-2000
Practice Address - Fax:563-359-5642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-23
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17316207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty